Prominent Ears – Otoplasty

Prominent ears are a developmental abnormality where the normal architecture of the ear has not developed and the ear becomes clearly prominent and cup shaped. A fold in the ear referred to as the anti helix is typically absent and also the conchal bowl (close to the entrance of the ear canal) may be found to be deep.

The ear is made of pliable cartilage and is significantly developing in the first few years of life. The cartilage from birth, during the neonatal period is responsive to splinting in the event of prominent ears being noticed early. This can help mould the ear into the correct shape.

Most children become conscious of their prominent ears on entrance to school where teasing is common. Girls can often hide the developmental abnormality more than boys due to the fact that they grow their hair to cover their ears. The cartilage needs to develop significantly and not be too immature before the ear can be surgically corrected. This typically is around the age of 5-6.

Otoplasty

The surgery typically is aimed at recreating the ‘antihelical’ fold typically missing or making the conchal bowl more shallow. This is undertaken with an incision behind the ear and the anti helix is formed, the cartilage may be scored to keep its shape and stitches may be used to keep the cartilage in place.

The ear is carefully dressed with a head bandage that is often worn for 1 week post-operativeley. At this stage the dressings are taken down and the ears are notably bruised but clearly their position has usually been altered for the better. Most surgeons like to protect the ears during the night with a headband so that the cartilage is not sprung back inadvertently.

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